AFSA highlights growing food allergy epidemic

5 Jun 2024

This year, The Allergy Foundation of South Africa is focusing on food allergies to educate people on this increasingly common, and at times life-threatening, disorder.

Source: Supplied.

Food allergies have increased significantly in people of all ages around the world. In fact, this increase has been hailed as a “food allergy epidemic”!

“Food allergies have become more and more prevalent, particularly among children. This surge is being seen globally and has significant public health implications,” says Mike Levin, chief executive officer of the Allergy Foundation of South Africa (AFSA), the organisation driving World Allergy Week awareness in SA, which runs from Sunday, 23 June 2024 to Saturday, 29 June 2024.

“Some potential causes for this increase can be attributed to environmental factors, with cleaner environments possibly leading to under-stimulated immune systems (the “hygiene hypothesis”).

"Another possible cause is dietary changes, with children being exposed to allergenic foods later than before and people being exposed to changing food-processing methods, an increase in sugary, fatty, processed foods and a reduction in “whole” foods rich in antioxidants. Increased antibiotic and anti-acid use may also be contributors”

“Gut health and changes in the gut microbiome can also impact immune responses, contributing to food allergies,” advises Levin.

Claudia Gray, a paediatrician and allergologist at the Kids Allergy Centre and an allergy consultant at the Red Cross Children’s Hospital, says that in South Africa about 2.5% of children have a food allergy, and this is on the rise.

“This means that in South Africa, two or three out of every 100 children have a food allergy, and most schools will have several learners with a potentially life-threatening food allergy.”

Food allergy is everywhere, and everyone should know what it is. Parents, teachers, extended family members, those who work in food services, and the public in general should be able to recognise and manage food-allergy reactions appropriately.

To assist with educating and helping South Africans, AFSA has provided some key information on food allergies below:

What is a food allergy? A food allergy usually begins when a person is young and may continue throughout their lives.

Food allergies involve your immune system which can sometimes get confused and react to the proteins in certain foods - mistakenly thinking they are dangerous, which starts an immune response. Some people can also react to foods if they have a pollen allergy (hay fever). This is because their body can confuse the proteins in pollen with the proteins in certain foods.

Common food allergies include peanuts, tree nuts such as walnuts and cashews, eggs, cow’s milk, seafood, soy, and wheat. This list is by no means exhaustive and there are many other less common foods to which people are allergic.

What are the symptoms of a food allergy? The symptoms can vary depending on whether you’re having a mild or severe reaction. Usually, the symptoms of food allergy appear quickly – within seconds or minutes. But they can also take up to a few hours to develop.

Some of the symptoms of food allergy include:

Wheezing or breathing difficulties
Itchy red patches on the skin (hives)
Itching or tingling in your mouth
Feeling sick
Dizziness
Stomach pain

Unfortunately for some people, food allergies can be life-threatening if they cause a severe reaction called anaphylaxis which can lead to a sharp drop in blood pressure and possible cardiovascular collapse; the airways can become constricted due to swelling, making it difficult to breathe; and multiple organs can fail.

How to test for a food allergy: Obtaining a food-allergy diagnosis from a doctor with allergy expertise is key. An allergy specialist will take a very detailed history of any symptoms encountered with foods and then usually look for antibodies against food using the following methods:

Skin prick test, where small amounts of potential allergens are introduced into the skin using a tiny needle to see if they cause a red, itchy bump – which indicates an allergy.

A blood test, which measures the level of IgE antibodies in the blood in response to specific allergens.

A high level of antibodies to foods means the person may have a food allergy, but unless the levels are very high, it does not mean the person is definitely allergic. In some cases, the diagnosis must be confirmed (or disproven) by doing a food challenge:

For severe types of food allergy, an oral food challenge is done where small amounts of the suspected allergen are consumed under medical supervision to observe any reaction.

In milder forms of food allergy, suspected allergens may be removed from the diet and then reintroduced one by one to identify the culprit.

Elimination of foods should never be done without the guidance of an allergy-trained doctor.

How to manage and treat a food allergy? Food allergies can be scary as sometimes they can cause quite severe, and occasionally life-threatening reactions. But for other people, food allergies are mild.

People who suffer from a food allergy must make sure they avoid trigger foods. This also means checking labels carefully to see if there are any traces of the allergen in the ingredients. Remember to check non-food items too – such as skincare or even cleaning products as these can sometimes include allergens too.

As well as avoiding allergy-causing food, a doctor may also recommend having emergency treatments ready to use if needed. This can include an Epi-pen (adrenaline autoinjector) for people with severe reactions such as anaphylaxis. For those with severe food allergies, wearing an allergy-alert bracelet is a good idea, and teaching family and friends how to use an Epi-pen safely is also recommended.

Levin advises that patients can manage their food allergies well with help from an allergist.

"Food allergies are on the rise, but they can be managed. Start by educating yourself and then seeking medical assistance. A doctor will help you develop a management plan that will improve your quality of life."

A list of allergy-trained doctors can be found on the AFSA website.